Offered HH position - accepted - now worried....

[Marshall1]

I worked HH in the past...I had applied for a baylor weekend position (weekends plus one during the week) and got the position. I understand HH has changed a LOT in the past 10 years - I am organized and manage time well and understand there may be days I'm assigned 3 patients and others that I may be assigned 10. I also understand mileage..my concern is..I don't know..so much is said about OASIS etc. I know there is a lot of paperwork but I am hoping this will bring back some of my lack of enthusiasm for nursing in the sense I am away from the hospital - I left the hospital in the 90's to do HH, take a breather, change of pace, and enjoyed it.

Any thoughts?

[caliotter3]

I would not worry about it. If the employer wants you to do OASIS paperwork correctly, they will see that you learn what you need.

[KateRN1]

I whole heartedly disagree with the above. Home health is a completely different beast from the 90s. We've gone from fee-for-service to IPS to now PPS based on OASIS HHRG and therapy projection for reimbursement. OASIS was implemented in 2000 (IIRC) and is primarily used as an outcomes assessment tool, although it is also used for payment categorization. Few independent agencies do a thorough job of orienting RNs to the OASIS data set and most learn on their own or from others, some ask questions here. If you're really lucky, you'll find an agency that will pay for you to attend the OASIS Answers seminars to learn OASIS in and out, or your agency will have a COS-C on board who can help you learn. It is much more than meets the eye and is such an important tool, I can't understand why agencies don't want to invest in that education upfront. Agencies who do not implement a solid orientation program really do themselves and their patients a disservice. But I stand on that soapbox waaaaay too much around here.

To learn more about OASIS, see the CMS OASIS home page. Back in the 90s, we were ruled by HCFA, now it's CMS--same agency, different title. We no longer get paid per visit with all supplies accounted for, now we get an "episode payment" that includes bundled supplies and we're expected to utilize our payment and time judiciously. No more is that old adage true of "a visit made is a visit paid." It must all be justified as skillable and billable and documented with the right language.

Please read through the forum here, peruse the CMS website, and learn as much as you can going in, so you know how to recognize problems when you see them.

[Lucky724]

Wow! Sounds almost exactly like the situation I find myself in...the more I read on here about HH the more nervous I am about going ahead with this job offer...and it stinks because over all this position would be great for me personally..good luck